The ability to recover from a large perturbation requires a fast and powerful step in any plane of movement. Unfortunately, the process of aging results in a reduced ability to develop maximal and explosive force, as well as in deficits in static and dynamic postural control (Granacher 2008). Physical therapists frequently address these deficits with inconsistent results. Current treatment approaches to improve balance dysfunction have included specific balance training strategies, strength training, walking, Tai Chi, and multidimensional exercises however, few have showed consistent positive outcomes in balance (Orr 2006). Due to the need for powerful movements and inconsistent results in current strategies strength training could be replaced by high-velocity forms of power training and balance training by perturbation-based training programs (Granacher 2008).
Objectives:
The objectives of this page are to:
Review current fall prevention strategies
Review current literature on high-velocity power training
Highlight the benefits of power training in relation to traditional strength training
Recommend evidence based best practice in fall prevention strategy
Information About Current Fall Prevention Strategies
The National Council on Aging has many recommendations for fall prevention ranging from individual interviews to group exercise classes. The most common areas addressed are fear of falling, increasing activity levels, improving strength and balance, decreasing frailty, and increasing confidence. A complete list and description of the programs can be found on their website. The council also provides information on the cost associated with falls depicted in the infographic below.
The Council on Aging has an established review process for program developers to apply for possible inclusion on the list of falls prevention programs. According to their website, the programs approved through the process will also satisfy the criteria for Older Americans Act Title III-D support. Despite the reported success of these programs Orr et al report that muscle power and contraction velocity have demonstrated greater influence on functional performance, particularly in low intensity tasks, than has muscle strength (Orr 2006). Orr goes on to state that progressive high velocity resistance (power) training results in more robust adaptations in muscle power than does low velocity progressive resistance training.
Evidence for Use of High-Velocity Power Training Rice and Keogh performed a systematic review and concluded that both strength and power training can improve functional in older adults, but they suggest that power training may be more effective. In their review they site nine studies that concluded “Muscular power is more closely associated to performance in functional ADL that are essential to independent living” and “Decreases in muscular power are associated with an increased risk or incidence of falls” (Rice 2009). These results are similar to those by Granacher 2008 and Orr 2006 that showed a greater increase in function and decreased fall risk in high-velocity training groups versus traditional strength and balance training. Furthermore, Tschopp and colleagues also performed a systematic review of 11 studies and 337 participants that showed a small to medium effect on functional outcomes in favor of the power training compared with strength training (Tschopp 2011).
What are the Parameters for High-Velocity Power Training?
Several of the included studies provide tables of literature reviews including frequency, duration, and load, for this wiki the table of parameters created by Rice and Keogh’s systematic review are included at the end of the wiki. The consensus of research highlighted here is a training duration between 8 and 12 weeks and frequency of 2-3X/week. The load used in training varies a bit more and ranges from 35% - 75% of 1RM. Four studies based training load on % of BW, two of which used a participant’s BW, one used >2%BW and another used 4-12%BW. The trend in results leans towards a lighter training load done at higher velocity to elicit the power training. Common exercises used in the studies were bilateral leg press, knee extension, knee flexion, seated row, and seated chest press. High-velocity training was commonly defined as a concentric phase performed as rapidly as possible followed by an eccentric phase over 3 seconds and 10-15 seconds between repetitions. Cues like ‘‘1 . . . 2 . . . 3 . . . Go!’’ are common in power training.
Who should use High-Velocity Power Training?
Studies included sedentary healthy older adults, institutionalized participants over 85 years old, frail older adults, and simply older adults in general. Studies did report some adverse effects that included isolated incidences of exacerbation of osteoarthritis, a recurrence of chronic plantar fasciitis, minor musculoskeletal discomfort, chest pain, and joint pain. These symptoms were seen in both strength training and power training groups with no higher incidence in either group. These studies indicate that anyone healthy enough for physical therapy and traditional strength and balance training can participate in high-velocity power training.
References
Cadore, E. et al (2013) Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians. AGE 36:773–785. (for reference only). Granacher, U. Zahner, L. & Gollhofer, A. (2008) Strength, power, and postural control in seniors: Considerations for functional adaptations and for fall prevention. European Journal of Sport Science. 8:6, 325-340
Orr, R. et al. (2006) Power Training Improves Balance in Healthy Older Adults. Journal of Gerontology: Medical Sciences. Vol. 61A, No. 1, 78–85.
Reid, K.F. and R.A. Fielding. Skeletal muscle power: a critical determinant of physical functioning in older adults. Exerc. Sport Sci. Rev., Vol. 40, No. 1, pp. 4Y12, 2012.
Rice, J. Keogh, J. (2009) Power Training: Can it Improve Functional Performance in Older Adults? A Systematic Review. Int J Exerc Sci 2(2): 131-151.
Tschopp, M. Sattelmayer, M. Hilfiker, R. (2011) Is power training or conventional resistance training better for function in elderly persons? A meta-analysis. Age and Ageing. 40: 549–556
The ability to recover from a large perturbation requires a fast and powerful step in any plane of movement. Unfortunately, the process of aging results in a reduced ability to develop maximal and explosive force, as well as in deficits in static and dynamic postural control (Granacher 2008). Physical therapists frequently address these deficits with inconsistent results. Current treatment approaches to improve balance dysfunction have included specific balance training strategies, strength training, walking, Tai Chi, and multidimensional exercises however, few have showed consistent positive outcomes in balance (Orr 2006). Due to the need for powerful movements and inconsistent results in current strategies strength training could be replaced by high-velocity forms of power training and balance training by perturbation-based training programs (Granacher 2008).
Objectives:
The objectives of this page are to:
Source: www.ncoa.org/resources/falls-prevention-programs-saving-lives-saving-money-infographic-3/
Information About Current Fall Prevention Strategies
The National Council on Aging has many recommendations for fall prevention ranging from individual interviews to group exercise classes. The most common areas addressed are fear of falling, increasing activity levels, improving strength and balance, decreasing frailty, and increasing confidence. A complete list and description of the programs can be found on their website. The council also provides information on the cost associated with falls depicted in the infographic below.
The Council on Aging has an established review process for program developers to apply for possible inclusion on the list of falls prevention programs. According to their website, the programs approved through the process will also satisfy the criteria for Older Americans Act Title III-D support. Despite the reported success of these programs Orr et al report that muscle power and contraction velocity have demonstrated greater influence on functional performance, particularly in low intensity tasks, than has muscle strength (Orr 2006). Orr goes on to state that progressive high velocity resistance (power) training results in more robust adaptations in muscle power than does low velocity progressive resistance training.
Evidence for Use of High-Velocity Power Training
Rice and Keogh performed a systematic review and concluded that both strength and power training can improve functional in older adults, but they suggest that power training may be more effective. In their review they site nine studies that concluded “Muscular power is more closely associated to performance in functional ADL that are essential to independent living” and “Decreases in muscular power are associated with an increased risk or incidence of falls” (Rice 2009). These results are similar to those by Granacher 2008 and Orr 2006 that showed a greater increase in function and decreased fall risk in high-velocity training groups versus traditional strength and balance training. Furthermore, Tschopp and colleagues also performed a systematic review of 11 studies and 337 participants that showed a small to medium effect on functional outcomes in favor of the power training compared with strength training (Tschopp 2011).
What are the Parameters for High-Velocity Power Training?
Several of the included studies provide tables of literature reviews including frequency, duration, and load, for this wiki the table of parameters created by Rice and Keogh’s systematic review are included at the end of the wiki. The consensus of research highlighted here is a training duration between 8 and 12 weeks and frequency of 2-3X/week. The load used in training varies a bit more and ranges from 35% - 75% of 1RM. Four studies based training load on % of BW, two of which used a participant’s BW, one used >2%BW and another used 4-12%BW. The trend in results leans towards a lighter training load done at higher velocity to elicit the power training. Common exercises used in the studies were bilateral leg press, knee extension, knee flexion, seated row, and seated chest press. High-velocity training was commonly defined as a concentric phase performed as rapidly as possible followed by an eccentric phase over 3 seconds and 10-15 seconds between repetitions. Cues like ‘‘1 . . . 2 . . . 3 . . . Go!’’ are common in power training.
Who should use High-Velocity Power Training?
Studies included sedentary healthy older adults, institutionalized participants over 85 years old, frail older adults, and simply older adults in general. Studies did report some adverse effects that included isolated incidences of exacerbation of osteoarthritis, a recurrence of chronic plantar fasciitis, minor musculoskeletal discomfort, chest pain, and joint pain. These symptoms were seen in both strength training and power training groups with no higher incidence in either group. These studies indicate that anyone healthy enough for physical therapy and traditional strength and balance training can participate in high-velocity power training.
References
Cadore, E. et al (2013) Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians. AGE 36:773–785. (for reference only).
Granacher, U. Zahner, L. & Gollhofer, A. (2008) Strength, power, and postural control in seniors: Considerations for functional adaptations and for fall prevention. European Journal of Sport Science. 8:6, 325-340
“National Council on Aging” www.ncoa.org/healthy-aging/falls-prevention/falls-prevention-programs-for-older-adults/. Retrieved July 2017
Orr, R. et al. (2006) Power Training Improves Balance in Healthy Older Adults. Journal of Gerontology: Medical Sciences. Vol. 61A, No. 1, 78–85.
Reid, K.F. and R.A. Fielding. Skeletal muscle power: a critical determinant of physical functioning in older adults. Exerc. Sport Sci. Rev., Vol. 40, No. 1, pp. 4Y12, 2012.
Rice, J. Keogh, J. (2009) Power Training: Can it Improve Functional Performance in Older Adults? A Systematic Review. Int J Exerc Sci 2(2): 131-151.
Tschopp, M. Sattelmayer, M. Hilfiker, R. (2011) Is power training or conventional resistance training better for function in elderly persons? A meta-analysis. Age and Ageing. 40: 549–556